腹腔鏡下手術における術中回収式自己血輸血の有用性

抄録

Objective: We retrospectively reviewed laparoscopic surgery cases at our institution to assess the efficacy of intraoperative cell salvage (ICS).

Methods: Patients who underwent laparoscopic surgery patients with preoperative Gn-RH analogs and intraoperative blood loss ≧ 600 ml from January 2018 to April 2022 were included. Patients were divided into three groups: ICS, preoperative autologous blood transfusion (PABT), and no transfusions (non-use). Postoperative hemoglobin (Hb) levels, allogeneic transfusion, and complications were also compared. Patients who received both ICS and PABT were excluded. Complications were defined as Clavien-Dindo Grade 2 or higher, with p<0.05 deemed as significant.

Results: There were 224 cases of laparoscopic surgery: 127, 42, and 45 in the ICS, PABT, and non-use groups, respectively. There were no significant demographic differences between groups. The median decrease in Hb on postoperative day 1 was 1.7, 3.2, and 3.0 g/dl in the ICS, PABT, and non-use groups, respectively, that of the ICS group was significantly lower. Postoperative transfusions occurred in 1 (0.8%), 3 (7.1%), and 0 cases (0%) in the ICS, PABT, and non-use groups, respectively, there were more transfusions in the PABT group, although the difference was not statistically significant. Postoperative complications did not differ significantly between groups.

Conclusion: Patients who underwent ICS had a slower Hb decline and no increase in complications. ICS may reduce preoperative effort and patient stress compared to PABT, and effectively manage unpredictable heavy bleeding.